| NPI | 1528409844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 81618-20) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 85787) |
| 207R00000X Internal Medicine (Licence: PA MT204029) | |
| 207R00000X Internal Medicine (Licence: PA MD458793) | |
| Enumeration Date | 2013-07-15 |
| Last Update Date | 2023-07-27 |